HELP -- Husband taken off Roxicodone & changed to Suboxone?

Where do I start? ... Well, my 33 y/o husband has 2 bulging discs in his lower back that have caused him so much pain that he has been unable to walk at many points within the past 4 years... He initially began going to his PCP 3 years ago to get Percocet 10/325 ... after about two years of him going to his PCP, he was referred to a Pain Management doctor for the past year, who started him off with 120 Oxycontin AND 120 10/325 Percocet a month... Then, within the last 2 months switched him to 30mg Roxicodone to take 3 to 4 a day, then a month later bumped it to 4 to 5 a day. My husband said he didn't feel a true 'high' from the Roxicodone like he defiantly could with the Oxy & Percs... So on his last appt with his doctor on Thursday, he said he sometimes felt like 5 a day wasn't enough for the pain from those 2 bulging discs (yes, he does need to eventually have surgery, but now isn't an ideal time due to his work situation)... Anyhow, once he told the doc that 5 a day didn't help relieve his pain, he said the doc flat out said he must be addicted to this medicine & now wants him to take 8mg Suboxone 2 times a day. (((this has scarred the crap out of him.)))

Okay, so here's where my questions & concerns come in to play... He wasn't told exactly when to take the medicine -- like I have read on many websites that one should detox at least 2 or 3 days before beginning Suboxone so that they should go into W/D from the pain meds first -- WELL, before I could tell him what I read, he took his 1st 8mg pill within 24 hours of taking his last Roxxy... Is this bad?? What will happen?? Will he go into an even worse W/D? I have read many crazy stories online & I'm in freak-out-mode...

* Does anyone have any suggestions for me to give him to make this an easier process? * Can he take an Ambien to help with sleep? * Should the doc prescribe something like Xanax or Valium to help with symptoms of anxiety (he doesn't have that at this point, but I read of other people saying they had all this awful side effects!!) ... I just want to know how to maker this transition easier for him... * Will Suboxone help with his bulging disc pain?? Could that mean he will be on this forever?* What other symptoms do people to through?

Responses (2)

Let me see if I can sort this out for you. Before starting the suboxone the oxycodone must be out of his system at least 24 hours. Otherwise he will go into withdrawls. There is something called the COWS scale which is a test for severity of withdrawls symptoms that you take to see if you are in enough withdrawls to start taking the suboxone. Here is the website to get the scale:www.csam-asam.org/pdf/misc/COWS_​induction_flow_sheet.docScroll down and read all the info past the test to understand what needs to be done.

You will start the suboxone at a low dose such as 2 - 4 mg at first then another 2 - 4 mg every 3 hours until symptoms subside, maximum of 24-32 mg is suggested. Since he was prescribed only two a day do not take more than two every 12 hours after the initial dosing.

Suboxone does contain a pain reliever called buprenorphine. So there will be some pain relief still in his system.

Suboxone is addictive and should only be used for as short as time as possible.

As far as treating symptoms with a benzodiazapene such as xanax or ativan, some doctors will prescribe if needed. Up to the doctor really.

MANAGEMENT: During concomitant use of these drugs, patients should be monitored for potentially excessive or prolonged CNS and respiratory depression. Ambulatory patients should be counseled to avoid hazardous activities requiring mental alertness and motor coordination until they know how these agents affect them, and to notify their physician if they experience excessive or prolonged CNS effects that interfere with their normal activities.